| Objectives:Optical coherence tomography(OCT)is a kind of intracavitary imaging examination that uses near-infrared light to scan the coronary artery wall,and then analyzes the imaging by computer.Its resolution is as high as 10 ? M.it can accurately judge the morphological characteristics of plaque in vivo and clearly observe the three-layer structure of the coronary artery wall.This study is based on the high resolution of OCT,to explore the relationship between the levels of serum high-sensitivity C-reactive protein(hs-CRP)?interleukin-6(IL-6)and the thick-ness of fibrous cap of vascular lipid plaque in patients with coronary heart disease.By analyzing the correlation and characteristics between stable angina pectoris(SAP),unstable angina pectoris(UAP)and non ST segment elevation myocardial infarction(NSTEMI)patients.And discuss whether the high-sensitivity C-reactive protein and interleukin-6 can be used as routine clinical test indexes for patients with coronary heart disease,so as to predict the severity of coronary artery disease and the risk of cardiovascular events,and provide reference for the diagnosis,treatment,prevention and prognosis evaluation.Methods:From December 2018 to December 2019,patients diagnosed as coronary heart disease by coronary angiography in the cardiovascular department of the Second Affiliated Hospital of Kunming Medical University were selected,including 22 patients with stable angina pectoris(SAP),20 patients with unstable angina pectoris(UAP),and 15 patients with non ST elevation myocardial infarction(NSTEMI).Among all the 57 patients,43 were male and 14 were female,age(60.91 ±8.16)years old,BMI(24.06±2.20)kg/m2,41 cases with hypertension,21 cases with diabetes and 38 cases with smoking history;all the SAP,UAP and NSTEMI patients were diagnosed in accordance with the diagnosis standard of coronary heart disease(ischemic heart disease)revised by the international Heart Association and the World Health Organization in 1979.The basic data of each group were collected through the electronic medical record system of the Second Affiliated Hospital of Kunming Medical University.The data of the above three groups were divided into three groups:group A:SAP group,group B:UAP group,group C:NSTEMI group;On the second or the third day after admission(fasting for 10-12h),the venous blood was drawn and the levels of hs-CRP and IL-6 were measured by automatic biochemical analyzer.The fiber cap thickness of culprit vascular lipid plaque was measured by optical correlation tomography(OCT).Results statistical software spss25.0 was used.The measurement data were expressed as x ± s,and LSD-t test was used for comparison between groups.Pearson method was used for correlation analysis.p<0.05 was statistically significant.Results:1.The serum hs-CRP levels of all patients were(14.15 ± 5.16)mg/L,SAP group(10.50±1.48)mg/L,UAP group(12.57±2.38)mg/L,NSTEMI group(20.87±1.81)mg/L,respectively.There was significant difference in hs-CRP between sap group and UAP group,UAP group and NSTEMI group.SAP group and NSTEMI group(p<0.05).The level of hs-CRP in NSTEMI group was higher than that in SAP group and UAP group,and that in UAP group was higher than that in SAP group.2.The serum level of IL-6 was(133.75±44.73)pg/ml in all patients,(108.02±41.64)pg/ml in SAP group,(135.38±39.73)pg/ml in UAP group and(165.66±35.24)pg/ml in NSTEMI group.There was significant difference in IL-6 between sap group and UAP group,UAP group and NSTEMI group,SAP group and NSTEMI group(p<0.05).The level of IL-6 in NSTEMI group was higher than that in SAP group and UAP group,and that in UAP group was higher than that in SAP group.3.The thickness of the fibrous cap of the culprit was(85.60±38.87)um in all patients,(60.99±7.33)um in SAP group,(60.53±7.19)um in UAP group and(55.21±5.49)um in NSTEMI group.There was significant difference between sap group and UAP group,UAP group and NSTEMI group,SAP group and NSTEMI group(p<0.05).In NSTEMI group,the fiber cap thickness of culprit vascular lipid plaque was lower than that in SAP group and UAP group,and that in UAP group was lower than that in SAP group.4.The results of Pearson correlation analysis showed that the level of serum hs-CRP and the average level of IL-6 water were negatively correlated with the thickness of fibrous cap of vascular lipid plaque in patients with coronary heart disease(r:-0.286,p<0.05;r:-0.442,p<0.05)Conclusions:1.The levels of hs CRP and IL-6 in NSTEMI patients were significantly higher than those in SAP and UAP patients;2.In NSTEMI patients,the thickness of capillaries in culprit vessels was lower than that in SAP and UAP patients,and that in UAP patients was lower than that in SAP patients;3.The level of serum hs CRP and the average level of IL-6 in patients with coronary atherosclerotic heart disease were negatively correlated with the thickness of the fibrous cap of the culprit vascular lipid plaque. |
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